Provider Demographics
NPI:1306633037
Name:LOMELI, ROSANNA HALCON (PPS)
Entity type:Individual
Prefix:MRS
First Name:ROSANNA
Middle Name:HALCON
Last Name:LOMELI
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1358
Mailing Address - Country:US
Mailing Address - Phone:805-524-8037
Mailing Address - Fax:
Practice Address - Street 1:627 SESPE AVE
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1918
Practice Address - Country:US
Practice Address - Phone:805-524-8037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220018153101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool